"Yet by the time of his death, that surgery — with its horrific outcome — had taken its place in the annals of medical law. It had led to a landmark court ruling that fundamentally transformed how doctors deal with patients in evaluating the risks of potential treatment.

“This is probably one of the handful of most significant medicolegal cases in United States history,” said Jacob M. Appel, a doctor and bioethicist.

"The ruling, by a federal appeals court in Washington in 1972, declared that before a patient provided informed consent to surgery or other proposed treatment, a doctor must disclose the risks, benefits and alternatives that a reasonable person would consider relevant.

"Previously, the onus of soliciting that information had rested with the patient, and any description of risks was provided at the doctor’s discretion. A doctor had been considered negligent only when treatment was administered against the patient’s wishes.

“It would not be an exaggeration to say that the opinion is the cornerstone of the law of informed consent” to medical treatment, “not only in the United States, but in other English-speaking countries, too,” said Prof. Alan Meisel, who teaches law and psychiatry at the University of Pittsburgh School of Law."